Chimeric antigen receptor T cell therapy cardiotoxicity: a narrative review
G Sinigiani1, G Scapinello2, T Berno2
1Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padua, Via N. Giustiniani 2, Padua, 35121, Italy. giulio.sinigiani@phd.unipd.it.
Cardio-Oncology (London, England)
|July 7, 2026
Summary
Chimeric antigen receptor (CAR) T cell therapy can cause heart problems, including arrhythmias and heart failure. Early detection and tailored management are crucial for improving cardiovascular outcomes in patients receiving this innovative cancer treatment.
Area of Science:
- Oncology
- Cardiology
- Immunology
Background:
- Chimeric antigen receptor (CAR) T cell therapy offers a promising treatment for relapsed/refractory hematologic malignancies.
- Cardiovascular (CV) toxicity is an emerging concern with CAR T cell therapy, especially in elderly patients with pre-existing CV conditions.
Purpose of the Study:
- To provide a practical framework for recognizing and managing CAR T cell-related cardiotoxicity.
- To focus on pathophysiological mechanisms, clinical presentation, and management strategies for CAR T cell-induced cardiotoxicity.
Main Methods:
- This is a narrative review.
- The review synthesizes current knowledge on CAR T cell-related cardiotoxicity.
Main Results:
- Cytokine release syndrome (CRS), mediated by interleukin-6, is central to CAR T cell cardiotoxicity.
- Atrial arrhythmias and heart failure are common complications.
- Current management strategies are often based on general cardio-oncology guidelines, highlighting gaps in specialized approaches.
Conclusions:
- There is a need for improved risk stratification, surveillance, and tailored therapies for CAR T cell-related cardiotoxicity.
- Addressing these gaps is essential to enhance CV outcomes in patients undergoing CAR T cell therapy.
